Health-related quality-of-life measurement in hypertension - A review of randomised controlled drug trials

In hypertension, tolerability of drug treatment is important because indivi duals may see the use of antihypertensive medications as more troubling tha n their seemingly symptomless disease. This may result in noncompliance and ineffectual long term treatment. In the past 15 years, new antihypertensiv e medications have been marketed on the basis of the advantages they offer with regard to adverse effects and the unavoidable impact of such adverse e ffects on a person's quality of life. When related to health, quality of li fe refers to the physical, psychological and social dimensions of health th at are influenced by a person's experiences, beliefs, expectations and perc eptions. To measure this concept, many instruments, either generic or speci fic, may be used. The purpose of this study is to describe, by way of a cri tical review of the literature, the instruments that are most often used in the measurement of health-related quality of life (HR-QOL) in people using antihypertensive drug treatments. We carried out a search of the literatur e published in English in the period January 1966 to July 2000, looking for randomised controlled trials of antihypertensive drugs. Using the Medline database, we included 77 papers in our review. Our main finding suggests th at HR-QOL changes associated with antihypertensive treatment are measured w ith many different instruments. In almost all studies, at least 1 instrumen t specific to a health dimension was used, whereas not many used a generic instrument only. The most commonly measured HR-QOL dimensions were cognitiv e function, symptomatic well-being, sexual function, psychological well-bei ng, sleep dysfunction, social participation and general health perception. Since the choice of dimensions to measure depends not only on the disease b ut also on the drug, this review adds further evidence that a generic instr ument as well as a preference measurement should be added to a specific ins trument.